自拟消痞胃炎散治疗慢性非萎缩性胃炎65例疗效观察

目的:观察自拟消痞胃炎散治疗慢性非萎缩性胃炎的临床疗效。方法:基于随机、对照的原则将125例经胃镜确诊的患者随机分为两组。治疗组用自拟消痞胃炎散治疗;对照组用奥美拉唑+阿莫西林+替硝唑治疗。两组均治疗2个疗程,治疗结束后4周复查电子胃镜进行疗效对比分析。结果:治疗组65例中总有效率为95.4%;对照组60例中总有效率为83.3%。经X2检验,治疗组效果显著优于对照组(X2=4.863,P<0.05)。两组均以单纯浅表性胃炎疗效最好,伴胆汁反流型者疗效较差。结论:自拟消痞胃炎散治疗慢性非萎缩性胃炎费用低廉、简便易服,病人依从性高,临床疗效好,副作用少,值得推广应用。     

莫沙必利联合胃炎合剂治疗慢性萎缩性胃炎的效果观察

目的 探讨慢性萎缩性胃炎内科治疗的临床效果.方法 本次研究选择的对象共90例,均为本院2010年5月～2012年5月收治的慢性萎缩性胃炎患者,采用数字分组法分观察组50例和对照组40例,对照组单纯应用莫沙必利治疗,观察组在此基础上加用胃炎合剂治疗,回顾相关临床资料.结果 两组治疗前血细胞比容、血浆黏度差异无统计学意义（P＞0.05）,治疗后均降低,观察组下降幅度高于对照组,两组间差异有统计学意义（P＜0.05）.观察组50例中,显效42例,占84.0％;有效7例,占14.0％;无效1例,占2.0％;临床总有效率为98.0％.对照组40例中,显效25例,占62.5％;有效5例,占12.5％;无效10例,占25.0％;总有效率为75.0％.观察组疗效优于对照组（P＜0.05）.结论 对慢性萎缩性胃炎明确诊断,针对发病因素进行相应防控,并选择合理的药物积极治疗,可显著提高效果,改善患者的生存质量.     

黄芪建中汤加减治疗慢性浅表性胃炎所致慢性萎缩性胃炎的临床效果观察

目的探讨黄芪建中汤辨证加减治疗慢性浅表性胃炎迁延所致慢性萎缩性胃炎的临床疗效。方法 90例慢性浅表性胃炎所致慢性萎缩性胃炎患者,根据治疗方法不同分为对照组和观察组,每组45例。对照组患者接受常规西药治疗,观察组患者接受黄芪建中汤辨证加减治疗。对比两组患者临床疗效、治疗前后中医症候和体征积分、药物不良反应发生情况、复发情况。结果观察组患者总有效率为97.78%,高于对照组的75.56%,差异具有统计学意义(P<0.05)。治疗前,两组患者手足不温、纳呆便溏、乏力、嗳气反酸、胃胀、胃痛积分对比差异无统计学意义(P>0.05);治疗后,两组患者手足不温、纳呆便溏、乏力、嗳气反酸、胃胀、胃痛积分均较本组治疗前明显降低,且观察组降低程度大于对照组,差异具有统计学意义(P<0.05)。治疗期间两组患者均没有出现明显药物不良反应,观察组复发率2.22%明显低于对照组的15.56%,差异具有统计学意义(P<0.05)。结论黄芪建中汤辨证加减治疗慢性浅表性胃炎迁延所致慢性萎缩性胃炎的临床疗效满意,值得推广应用。     

Emphysematous gastritis associated with ulcerative esophagitis

Emphysematous gastritis is a rare form of gastritis characterized by gaseous dissection of the stomach wall usually secondary to invasion by gas forming organisms, corrosive ingestion, trauma, or gastric infarction. We report a unique case of emphysematous gastritis secondary to ulcerative esophagitis without an underlying history of trauma, ischemia, or ingestion of corrosive agents. The patient responded well to conservative management. Emphysematous gastritis is a deadly infectious disease. Early recognition and management are crucial as there is no specific approach to treatment despite advances in medical science.     

Risk of gastroduodenal ulcer in gastritis

The present evidence suggests that chronic gastritis is strongly associated with peptic ulcer disease. Gastritis, particularly in antrum, is nearly invariably present in patients with peptic ulcer. Gastritis is a progressive disease which begins as a superficial inflammation and progresses to atrophic gastritis. Gastritis can be considered to lower resistance of the gastric mucous membrane but it may also affect secretion of acid and pepsins from oxyntic mucosa. The presence or absence of gastritis, and its involvement in antral and/or body mucosa, can be considered to reflect the risk and probability of a person to contract peptic ulcer. Estimations of the risks of coexistent peptic ulcer in different types and grades of gastritis suggest that the relative risk (RR) of coexistent peptic ulcer disease is markedly increased in the presence of gastritis in general (RR = 7-10), as compared to patients who have a normal, non-gastritic stomach (RR = 1). This risk is particularly high in patients with gastritis of B type (atrophic gastritis is in antrum but body mucosa is non-atrophic) in whom the coexistent peptic ulcer is 20-30 times more common (RR = 20-30) than in patients who have normal stomach. On the other hand, the risk of peptic ulcer disease is low in patients who show marked atrophic alterations in the gastric body mucosa (A or AB types of gastritis), the risk being in these patients even lower (RR below 1) than that in patients with normal, non-gastritic stomach.     

麦滋林－S治疗慢性萎缩性胃炎

慢性萎缩性胃炎５４例，随机分为２组。麦滋林－ｓ组３１例（男性２４例，女性７例；年龄５２±ｓ９ａ）功，用麦滋林１颗粒０．６７９，冲服，ｔｉｄ；三九胃泰组２３例（男性１８例，女性５例；年龄４９＋１０的，用三九胃泰胶羹１０ｇ，ｐｏ，ｂｉｄ。２组均３ｍｏ为一个疗程。前组总有效率８４％，明显高于后组５２％（Ｐ＜０．０５）。提示麦滋林－ｓ是一种治疗慢性萎缩性胃炎有前途的药物。     

Helicobacter pylori and atrophic gastritis.

Sixty-four consecutive patients which on upper gastrointestinal endoscopy had endoscopic signs of atrophic body gastritis were investigated with standard histology examinations of gastric biopsies, serology and/or culture for Helicobacter pylori and with standard blood chemistry profile. A histologic diagnosis of atrophy could be made in only 27 of the 64 patients (42%). Of these 27 patients, 5 had the pernicious anaemia (PA) type (19%), 22 had not (81%). Past and/or present H. pylori infection was found in 16/22 non-PA patients (73%) but in none of the PA patients (p = 0.00572). The present study thus confirms earlier findings that non-PA type atrophic body gastritis is more common than the PA type and suggests that, as opposed to PA-type atrophy, it is related to H. pylori infection.     

Atrophic gastritis as a cause of hyperhomocysteinaemia

BACKGROUND: Hyperhomocysteinaemia is an independent risk factor for atherosclerosis. It is often related to low levels of vitamin B12 and/or folate, enzymatic co-factors of methionine metabolism. Atrophic gastritis, often caused by Helicobacter pylori infection, may impair vitamin absorption. AIM: To assess whether the presence of atrophic gastritis is associated with hyperhomocysteinaemia via deficiency of its vitamin co-factors. METHODS: Thirty-one patients with atrophic gastritis were recruited. The control group consisted of 28 patients with non-atrophic gastritis, matched with patients for sex, age and body mass index. The presence and degree of gastric atrophy were assessed by histology. H. pylori infection was assessed by histology/serology. Blood samples were collected for the measurement of homocysteine, vitamin B12 and folates. RESULTS: Multiple logistic regression analysis showed that atrophic gastritis (odds ratio, 5.3; 95% confidence interval, 1.23-25.26; chi2=5.2; P=0.01) and low vitamin B12 (odds ratio, 3.7; 95% confidence interval, 1.03-22.08; chi2=3.6; P<0.05) were both predictors of hyperhomocysteinaemia. None of the other variables considered in the analysis, including H. pylori status, showed a significant association with hyperhomocysteinaemia. CONCLUSIONS: The present study suggests that atrophic gastritis, rather than H. pylori infection per se, may be a contributing factor to hyperhomocysteinaemia, possibly via vitamin B12 malabsorption.     

Therapeutic effects of sofalcone on experimental gastritis

A study was made on the therapeutic effects of sofalcone (SU-88), an antiulcer agent, on erosive and atrophic gastritis induced experimentally by 6-month administration of 5 mmol/l of sodium taurocholate (TCA) in rats. A standard meal including sofalcone of 0.25% and 1.0% shortened the total length of erosions, normalized the mucosal thickness, and reduced collagenous fibers in the gastric mucosa in one month. The doses administered were 116.3 mg and 486.1 mg/kg/week for one month. Sofalcone, thus, had a good therapeutic effect on experimental erosive and atrophic gastritis in rats.